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Predictors of Clinical Inertia and Type 2 Diabetes: Assessment of Primary Care Physicians and Their Patients.
Isajev, Nemanja; Bjegovic-Mikanovic, Vesna; Bukumiric, Zoran; Vrhovac, David; Lalic, Nebojsa M.
  • Isajev N; Centre School of Public Health and Management, Faculty of Medicine, University of Belgrade, dr Subotica 15, 11000 Belgrade, Serbia.
  • Bjegovic-Mikanovic V; Centre School of Public Health and Management, Faculty of Medicine, University of Belgrade, dr Subotica 15, 11000 Belgrade, Serbia.
  • Bukumiric Z; Institute of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, dr Subotica 15, 11000 Belgrade, Serbia.
  • Vrhovac D; University Children's Hospital, Tirsova 10, 11000 Belgrade, Serbia.
  • Lalic NM; Clinic for Endocrinology, Diabetes and Metabolic Diseases, Faculty of Medicine, University of Belgrade, dr Subotica 13, 11000 Belgrade, Serbia.
Int J Environ Res Public Health ; 19(8)2022 04 07.
Article in English | MEDLINE | ID: covidwho-1809849
ABSTRACT
With the growing prevalence and complex pathophysiology of type 2 diabetes, many patients fail to achieve treatment goals despite guidelines and possibilities for treatment individualization. One of the identified root causes of this failure is clinical inertia. We explored this phenomenon, its possible predictors, and groups of patients affected the most, together with offering potential paths for intervention. Our research was a cross-sectional study conducted during 2021 involving 52 physicians and 543 patients of primary healthcare institutions in Belgrade, Serbia. The research instruments were questionnaires based on similar studies, used to collect information related to the factors that contribute to developing clinical inertia originating in both physicians and patients. In 224 patients (41.3%), clinical inertia was identified in patients with poor overall health condition, long diabetes duration, and comorbidities. Studying the changes made to the treatment, most patients (53%) had their treatment adjustment more than a year ago, with 19.3% of patients changing over the previous six months. Moreover, we found significant inertia in the treatment of patients using modern insulin analogues. Referral to secondary healthcare institutions reduced the emergence of inertia. This assessment of primary care physicians and their patients pointed to the high presence of clinical inertia, with an overall health condition, comorbidities, diabetes duration, current treatment, last treatment change, glycosylated hemoglobin and fasting glucose measuring frequency, BMI, patient referral, diet adjustment, and physician education being significant predictors.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Diabetes Mellitus, Type 2 / Physicians, Primary Care Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Diabetes Mellitus, Type 2 / Physicians, Primary Care Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Year: 2022 Document Type: Article